Pathophysiological consequences of different cardiac support regimens in cardiorespiratory insufficiency

Introduction: Veno-arterial extracorporeal membrane oxygenation (VA ECMO) is a rapidly applicable type of mechanical circulatory support that overcomes acute hemodynamic breakdowns, whether in acute or chronic heart failure or cardiac arrest. In recent years, the method has seen a very significant increase in use. VA ECMO can fully replace the function of the heart and lungs, delivering about 5 l / min of fully saturated blood. However, the method is burdened with a number of risks. Currently much-discussed issue is the effect of circulatory support on left ventricular residual function as VA ECMO increases its work and the risk of developing left ventricular distension and subsequent pulmonary edema. A detailed analysis of these pathophysiological mechanisms is a key objective of this work. Methods: The focus of the work is three series of experiments on a large biomodel (domestic pig). First, we developed a new model of acute hypoxic-ischemic heart failure by proximal occlusion of one of the main branches of the left coronary artery with a balloon catheter with a lumen for controlled perfusion of deoxygenated venous blood behind the balloon. Furthermore, we monitored the hemodynamic response and energy parameters in detail in the porcine biomodel of acute and chronic heart failure with a gradual..